Covered diabetic supplies for Kaiser Permanente Colorado Option plans

Kaiser Permanente Colorado Option plans cover diabetic supplies at a $0 copay, with no deductible or coinsurance. The items below are covered when medically necessary and you get them from your health plan's pharmacies or locations.

Continuous Glucose Monitors and Components (receivers, sensors, transmitters)

Covered by medical (DME)

Insulin Pumps

Covered by Pharmacy Benefit

Blood Glucose Monitors and Test Strips

Covered by Pharmacy Benefit

Lancets/Syringes/Needles

Covered by Pharmacy Benefit

Other Diabetic Supplies

Covered by Pharmacy Benefit and Medical Benefit (DME)

Where can I learn more about Prescription Drug benefits?

For a complete list of diabetic supplies that are available at the pharmacy, review the Colorado Marketplace Formulary. Visit our provider directory to find doctors and locations.
 

Where can I learn more about Durable Medical Equipment (DME) products?

Durable medical equipment (DME) and supplies like insulin pumps and glucose monitors are available through our vendors. Please contact your doctor or endocrinology specialist to discuss which devices and supplies you need. They can enter an authorization request for you. The vendor will then reach out to make sure you get the covered items you need.

*Requires prior authorization review

Prior Authorization

What if my diabetic supplies requires prior authorization?

If your plan requires prior authorization for a diabetic supply, your healthcare provider (doctor, nurse practitioner, etc.) will give us information about your diagnosis, treatment history and other relevant information to request prior authorization. If the prior authorization request is approved, you will pay a $0 cost share, not subject to a deductible.

How to request prior authorization for diabetic supplies

Patients:

Your doctor will need to submit a prior authorization request.

Providers: 

Pharmacy Benefit:  Please request prior authorization by completing and submitting the KPCO HMO Medication Request Form to the KPCO Pharmacy Authorization Service by faxing the form to 1-858-357-2615.

Medical Benefit: Please submit an online prior authorization request through the provider portal.